Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/118909
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Entrainment and high-density three-dimensional mapping in right atrial macroreentry provide critical complementary information: entrainment may unmask "visual reentry" as passive |
Author: | Pathik, B. Lee, G. Nalliah, C. Joseph, S. Morton, J.B. Sparks, P.B. Sanders, P. Kistler, P.M. Kalman, J.M. |
Citation: | Heart Rhythm, 2017; 14(10):1-9 |
Publisher: | Elsevier |
Issue Date: | 2017 |
ISSN: | 1547-5271 1556-3871 |
Statement of Responsibility: | Bhupesh Pathik, Geoffrey Lee, Chrishan Nalliah, Stephen Joseph, Joseph B. Morton... Prashanthan Sanders ... et al |
Abstract: | With the recent advent of high-density (HD) 3-dimensional (3D) mapping, the utility of entrainment is uncertain. However, the limitations of visual representation and interpretation of these high-resolution 3D maps are unclear.The purpose of this study was to determine the strengths and limitations of both HD 3D mapping and entrainment mapping during mapping of right atrial macroreentry.Fifteen patients were studied. The number and type of circuits accounting for ≥90% of the tachycardia cycle length using HD 3D mapping were verified using systematic entrainment mapping. Entrainment sites with an unexpectedly long postpacing interval despite proximity to the active circuit were evaluated.Based on HD 3D mapping, 27 circuits were observed: 12 peritricuspid, 2 upper loop reentry, 10 lower loop reentry, and 3 lateral wall circuits. With entrainment, 17 of the 27 circuits were active: all 12 peritricuspid and 2 upper loop reentry. However, lower loop reentry was confirmed in only 3 of 10, and none of the 3 lateral wall circuits were present. Mean percentage of tachycardia cycle length covered by active circuits was 98% ± 1% vs 97% ± 2% for passive circuits (P = .09). None of the 345 entrainment runs terminated tachycardia or changed tachycardia mechanism. In 8 of 15 patients, 13 examples of unexpectedly long postpacing interval were observed at entrainment sites located distal to localized zones of slow conduction seen on HD 3D mapping.Using HD 3D mapping, "visual reentry" may be due to passive circuitous propagation rather than a critical reentrant circuit. HD 3D mapping provides new insights into regional conduction and helps explain unusual entrainment phenomena. |
Keywords: | Atrial flutter Atrial macroreentry Atrial tachycardia Entrainment Three-dimensional electroanatomic mapping |
Rights: | © 2017 Heart Rhythm Society. All rights reserved. |
DOI: | 10.1016/j.hrthm.2017.06.021 |
Grant ID: | NHMRC |
Published version: | http://dx.doi.org/10.1016/j.hrthm.2017.06.021 |
Appears in Collections: | Aurora harvest 8 Medicine publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.